Self-Disclosure Settlement Agreement

Nearly seven years after the first publication, The transaction contract resolves the potential liability of home health care providers (FCA) in several categories of alleged offences, including filing claims for home health services that failed to provide sufficient personal documentation, claims with false or invalid certificates, and violations of The Stark Act and the Anti-Kickback Act, based on allegedly inappropriate compensation agreements with physicians. Allegations of strong and anti-kickback relate to compensation in the form of marketing expenses, payments to a restaurant owned by family members of a referring physician, provision of free equipment and staff services for a reference medical practice, medical director and rent provisions to physicians that have not been properly justified in writing, and insufficient documentation of other financial arrangements. Home health care providers did not give liability under the terms of the transaction agreement. Suppliers can choose to report directly to the DOJ. Unlike the OIG and CMS, the DOJ does not have a formal self-certification protocol. In general, the way forward is to disclose the USAO in the district where the supplier is located. Prior to the disclosure and identification of a reported event, the institution should review and assess potential state losses, take corrective action and prepare a written report consistent with the OIG requirements set out in the self-certification guidelines and the checklist contained by the IGO. For example, information should include: Voluntary disclosure also carries risks. For example, after the revelation, the government may request further reviews, including extension to other distinctions involving the same staff or members of the research team, as well as a more in-depth investigation of those involved in the reported behaviour. The OIG will provide detailed information on the process and scope of the review conducted to determine the reporting behaviour and the corrective actions that have been planned, implemented and completed. After disclosure, the OIG will generally attempt to resolve most cases through a negotiated solution with the disclosure firm. Success depends on the severity and extent of the fault involved, as well as the adequacy of the review and correction plan.

Given that federal research funding will increase in 2020 and the NIH is expected to receive significant non-financial bonuses again, attention to these issues is not expected to decrease. Voluntary self-certification remains both a legal and commercial decision, which must be carefully weighed both with respect to the underlying legal obligation and the risks and benefits it entails for the institution. While there is less security on the trial, there are some factors that may weigh in favor of self-certification in the U.S. Attorney`s Office. Finally, a fourth vehicle is self-certification for suppliers and suppliers to report potential violations directly to the DOJ, usually through the U.S. local attorney`s office. There is no formal protocol or self-report instruction to the U.S. Attorney`s Office and, as a result, there is less certainty about the outcome. For example, while the SDP is clear that the OIG uses a multiplier of 1.5 times individual damages as a measure of liquidation, the only self-certification guideline for the DOJ is that the FCA provides that damage is limited to double the damage when a supplier/supplier voluntarily discloses an infringement and certain conditions are met. The accounts under the SRDP are based on a percentage of the overpayment, i.e. the amount of claims filed in violation of the prohibition of settlement of the strong law.

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